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. 2011 Jul;86(7):901-6.
doi: 10.1097/ACM.0b013e31821da193.

Using behavior change plans to improve medical student self-care

Affiliations

Using behavior change plans to improve medical student self-care

Robert F Kushner et al. Acad Med. 2011 Jul.

Abstract

Purpose: To describe an innovative approach to teaching medical students the principles and practice of health behavior change and self-care using a behavior change plan (BCP).

Method: Second-year medical students at Northwestern University Feinberg School of Medicine (n = 343) took a required Healthy Living unit in 2008 or 2009. They completed a BCP project in which they selected a personal behavior to change (exercise, nutrition, sleep, personal habits/hygiene, study/work habits, or mental/emotional health), set a goal, tracked progress, and self-assessed success. The authors employed a one-group posttest-only design to conduct a quantitative analysis and a qualitative evaluation of students' BCPs and their attitudes concerning the project.

Results: Among the 343 students, 299 (87.2%) set BCP goals related to exercise, nutrition, or sleep. BCP outcomes varied: 139 students (40.5%) achieved their goal, 170 (49.6%) failed to do so, and 34 (9.9%) were uncertain. Factor analysis produced two independent attitude scales: utility (α = .80) and burden (α = .67). Logistic regression showed that success approached statistical significance only in the sleep behavior category and for the utility attitude scale. Qualitative case reports provide insights about BCP targets, management, and results. After completing the assignment, 274 (79.9%) of the students considered themselves to be healthier, and 281 (81.9%) indicated they would use the process again.

Conclusions: Completing a BCP is a valuable and effective exercise that enables medical students to practice the strategies and skills and experience the obstacles of changing health behavior.

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Figures

Figure 1
Figure 1
Exercise log for Student 1. His behavior change plan (BCP) goal was to get 60 minutes of exercise 5 times per week at a local gym. At baseline (weeks 1–4), he exercised 0–3 times per week, After implementing the BCP for 6 weeks, he was able to steadily increase his exercise to 3–5 times per week.
WeekDays exercised
13
20
31
41
53
65
75
83
95
Figure 2
Figure 2
Fruit and vegetable intake log for Student 2. Her behavior change plan (BCP) goal was to increase her fruit and vegetable consumption to 4 servings per day. At baseline (weeks 1–3), she consumed 1–2 servings per day. After implementing the BCP for 6 weeks, she was able to increase her intake to 3.5 servings per day. Dark bars indicate fruit consumption; light bars, vegetable consumption. A indicates exam week; B, start of BCP.
DayServings of FruitServings of Vegetables
111
211
310
411
510
610
710
811
911
1011
1110
1211
1311
1411
1511
1610
1710
1811
1910
2010
2110
2210
2313
2411
2512
2612
2713
2810
2911
3012
3114
3213
3311
3413
3513
3622
3713
3814
3824
4011
4112
4214
4314
4423
4512
4623
4712
4813
4913
5011
5112
5210
5312
5411
5512
5612
5713
5813
5913
6013

Comment in

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